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This Is Assisted Dying: A Doctor's Story of Empowering Patients at the End of Life by Stefanie Green
ncrozier's review against another edition
5.0
This book is such a good introduction to assisted dying. The combination of memoir and facts makes it an enjoyable read, helps us understand the nuances of the topic, and incorporates empathy and storytelling.
taliatiss's review against another edition
4.0
The only thing of value to people considering reading this: I preferred the book to the audiobook. Perhaps it's because I listen at 2x speed, but Dr. Green's narration didn't contribute to my experience of the book, and I found the parts I read more poignant than the parts I listened to.
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I picked this up with the intention of clarifying and challenging my beliefs about autonomy, suffering, and what a life worth living looks like. I'm not a medical provider, but I will soon be a licensed mental healthcare provider who works with a fair number of suicidal clients. So I think I entered this book with less squeamishness than some might. I'm not afraid of thinking about death, nor am I uncomfortable engaging with people who are considering it (though the circumstances of my future clients will be quite different from Dr. Green's patients).
And yet, as I read I could feel the book weathering an emotional barrier I hadn't realized I had. Intellectually, I fully support MAiD for individuals with the capacity to consent and a reasonable expectation of no meaningful reprieve from intense physical suffering and/or neurological deterioration. But that doesn't mean I was emotionally prepared for vignettes of the end of life - often poignant, sometimes distressing, and always delivered with Dr. Green's measured and compassionate narrative.
I'm glad I read this book, not only because it provided an ethical, social, and emotional context for MAiD, but because confronting death alongside Dr. Green meant considering everything I wanted to accomplish with the people I love before they and I are out of time. I reflected on funerals of friends, loved ones, and clients. I thought about how few people are afforded the opportunity to live with the intention and clarity of knowing how much time you have left.
I also think I needed to hear Dr. Green talk about burn out and building her own life worth living.
But a big part of me wishes this book had come out after more legislative changes had been made in Canada. Dr. Green details many of these changes in the epilogue, such as striking down the need for “reasonable foreseeability of natural death” but the contents of the book take place before she has to administer MAiD after these legislative changes. I know it could be politically risky for Dr. Green to write about situations that supporters of MAiD might find controversial, but it's part of what I'm here for. I noticed Dr. Green didn't tell the stories of anyone who changed their mind, even though she did have such patients. I noticed that the only mental health vignette she provided was one in which she feared for her safety when meeting with a mentally ill man who was requesting MAiD. These decisions shape how Canadians think about MAiD, and while Dr. Green makes an effort to discuss grey areas at times, she shied away from some topics (like MAiD for cases where mental illness is the sole medical condition) by asking questions but not toughing potential answers. And it is fair if that's where she was, ethically, when she wrote this book. Since then, she has tweeted in support of MAiD in the aforementioned mental illness cases, but I'm not aware of her ever meaningfully discussing disability activists' concerns.
If I were to lay out all my thoughts about MAiD for cases where mental illness is the sole medical condition, we would be here for a while. Discrimination against individuals with mental illness is real, I've seen it from laypeople and mental healthcare providers alike, and I believe in the rights of the mad and mentally ill. But the Canadian government cites "depression and personality disorders" as potential examples of "a serious and incurable illness, disease or disability". And that is so dangerous and anti-science it makes me want to scream.
Over the next months, I'll be reading Jean Marmoreo's The Last Doctor, and Marsha Linehan's Building a Life Worth Living, and maybe I'll actually lay out my thoughts on this topic. But like Dr. Green, I have more questions than answers.
----
I picked this up with the intention of clarifying and challenging my beliefs about autonomy, suffering, and what a life worth living looks like. I'm not a medical provider, but I will soon be a licensed mental healthcare provider who works with a fair number of suicidal clients. So I think I entered this book with less squeamishness than some might. I'm not afraid of thinking about death, nor am I uncomfortable engaging with people who are considering it (though the circumstances of my future clients will be quite different from Dr. Green's patients).
And yet, as I read I could feel the book weathering an emotional barrier I hadn't realized I had. Intellectually, I fully support MAiD for individuals with the capacity to consent and a reasonable expectation of no meaningful reprieve from intense physical suffering and/or neurological deterioration. But that doesn't mean I was emotionally prepared for vignettes of the end of life - often poignant, sometimes distressing, and always delivered with Dr. Green's measured and compassionate narrative.
I'm glad I read this book, not only because it provided an ethical, social, and emotional context for MAiD, but because confronting death alongside Dr. Green meant considering everything I wanted to accomplish with the people I love before they and I are out of time. I reflected on funerals of friends, loved ones, and clients. I thought about how few people are afforded the opportunity to live with the intention and clarity of knowing how much time you have left.
I also think I needed to hear Dr. Green talk about burn out and building her own life worth living.
But a big part of me wishes this book had come out after more legislative changes had been made in Canada. Dr. Green details many of these changes in the epilogue, such as striking down the need for “reasonable foreseeability of natural death” but the contents of the book take place before she has to administer MAiD after these legislative changes. I know it could be politically risky for Dr. Green to write about situations that supporters of MAiD might find controversial, but it's part of what I'm here for. I noticed Dr. Green didn't tell the stories of anyone who changed their mind, even though she did have such patients. I noticed that the only mental health vignette she provided was one in which she feared for her safety when meeting with a mentally ill man who was requesting MAiD. These decisions shape how Canadians think about MAiD, and while Dr. Green makes an effort to discuss grey areas at times, she shied away from some topics (like MAiD for cases where mental illness is the sole medical condition) by asking questions but not toughing potential answers. And it is fair if that's where she was, ethically, when she wrote this book. Since then, she has tweeted in support of MAiD in the aforementioned mental illness cases, but I'm not aware of her ever meaningfully discussing disability activists' concerns.
If I were to lay out all my thoughts about MAiD for cases where mental illness is the sole medical condition, we would be here for a while. Discrimination against individuals with mental illness is real, I've seen it from laypeople and mental healthcare providers alike, and I believe in the rights of the mad and mentally ill. But the Canadian government cites "depression and personality disorders" as potential examples of "a serious and incurable illness, disease or disability". And that is so dangerous and anti-science it makes me want to scream.
Over the next months, I'll be reading Jean Marmoreo's The Last Doctor, and Marsha Linehan's Building a Life Worth Living, and maybe I'll actually lay out my thoughts on this topic. But like Dr. Green, I have more questions than answers.
fluffernutter's review against another edition
DNF
I'm just not interested in Dr Green's emotional or logistical journey.
I'm just not interested in Dr Green's emotional or logistical journey.
ascoular's review against another edition
5.0
I’ve always been interested in physician-assisted death and this memoir answers every question I’ve ever had about it. The book is wonderfully planned. Once you get through a chapter, the author answers the next logical question. I really felt like this doctor worked within the patient-centered paradigm and that her patients were so lucky to have her! I enjoyed that she talked about maintaining work-life balance and boundaries (something non-fiction books almost never talk about).
My big takeaway was this little throwaway line: [physician assisted death] is “less about dying and more about how to live.” There’s a huge right to privacy issue at stake here. In the wake of Roe v. Wade possibly being overturned, I wonder how it will affect physician-assisted death and dignity in dying. If birth is at issue, death isn’t far behind.
I highly recommend this book if you’re confused about the difference between physician-assisted death and palliative care.
Her last patient’s passing is the kind of image that will be seared into my memory.
The epilogue also wrote about everything I would have googled after reading the book (updates in Canada, the US, and worldwide). The COVID-19 update was a bit harrowing, especially given how much compassion the author exuded in her practice before the pandemic and how that adapted due to safety concerns.
My big takeaway was this little throwaway line: [physician assisted death] is “less about dying and more about how to live.” There’s a huge right to privacy issue at stake here. In the wake of Roe v. Wade possibly being overturned, I wonder how it will affect physician-assisted death and dignity in dying. If birth is at issue, death isn’t far behind.
I highly recommend this book if you’re confused about the difference between physician-assisted death and palliative care.
Her last patient’s passing is the kind of image that will be seared into my memory.
The epilogue also wrote about everything I would have googled after reading the book (updates in Canada, the US, and worldwide). The COVID-19 update was a bit harrowing, especially given how much compassion the author exuded in her practice before the pandemic and how that adapted due to safety concerns.